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General NPI Number Information
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NPI Number | 1528393071
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Entity Type | Individual
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Provider Name | ERIK SNOOK PA-C
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Gender | Male
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Dates
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Enumeration Date | 10/15/2009
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Last Update Date | 10/15/2009
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Provider Practice Location Address
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Address Line | DEPARTMENT OF THE ARMY 15244
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City | SOEUL
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State | YOUNGSUN
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Zip | APO AP 96205
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Country | KR
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Telephone | 82279175400
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Fax |
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Provider Business Mailing Address
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Address Line | 5505 SAFFRON WAY
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City | SAN ANTONIO
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State | TX
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Zip | 78238-2304
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Country | US
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Telephone | 210-912-4063
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 1091017
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License Number State | TX
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